Technology Facilitated Behavioral Intervention for Depression among Diverse Patients in Ambulatory Oncology

技术促进了门诊肿瘤科不同患者抑郁症的行为干预

• 批准号: 10577738
• 负责人: BETINA YANEZ
• 金额: $ 62.03万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-01 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10577738
• 关键词: Address; Adherence; Adoption; American Society of Clinical Oncology; Anxiety; Area; Behavior Therapy; Behavioral; Behavioral Model; Cancer Patient; Caring; Characteristics; Chicago; Clinic; Clinical; Clinical Management; Clinical Oncology; Cognitive; Combined Modality Therapy; Data; Depression screen; Diagnosis; Disease; Distress; Effectiveness; Electronic Health Record; Emergency department visit; Ethnic Origin; Evaluation; Evidence based intervention; Evidence based treatment; General Population; Goals; Guidelines; Health; Health Benefit; Health Personnel; Health system; Home; Income; Individual; Information Systems; Information Technology; Internet; Intervention; Language; Maintenance; Major Depressive Disorder; Malignant Neoplasms; Measurement; Measures; Mediator; Medicine; Mental Depression; Mental Health; Modeling; Oncology; Outcome; Outcome Study; Patient Care; Patient Outcomes Assessments; Patient Triage; Patients; Population; Prevalence; Process; Race; Recommendation; Recording of previous events; Self Efficacy; Severities; Severity of illness; Site; Specificity; Symptoms; System; Technology; Testing; Time; Training; United States Preventative Services Task Force; Universities; Work; behavioral health; cancer therapy; comorbidity; computerized; depressive symptoms; diagnostic criteria; effectiveness evaluation; effectiveness/implementation trial; ethnic diversity; evidence base; experience; health information technology; health related quality of life; health service use; implementation evaluation; implementation framework; improved; individualized medicine; instrument; metropolitan; mortality; operation; patient portal; primary outcome; programs; psychologic; racial diversity; recruit; screening; secondary outcome; sex; standard care; standard of care; suicidal risk; symptomatology; technology platform; tool; treatment as usual

Abstract Depressionis one of the most common psychological comorbidities experienced throughout the cancercontinuum. Elevated depressive symptoms in oncology patients is a major concern as unmanaged depressive symptoms in cancer patients is associated with poor health-related quality of life (HRQoL), poor adherence to cancer treatments, delayed return to work and baseline function, greater emergency department visits, greater risk of suicide, and higher all-cause mortality. Behavioral interventions for the management of depression are efficacious, but scalability and implementation of these evidence-based interventions in oncology is limited. Health interpretation capture behavioral populations. information technologies (HIT) provide an ideal opportunity t o expedite the administration, scoring, and of depression screening with well-validated, brief and precise measurement tools that can actionable data to screen for depression, and deliver pragmatic and scalable evidence-based interventions that are proven to reduce depressive symptomatology across various other Despite the benefits of these HITs,use of technology-based models to screen and deliver evidence-based behavioral treatments that address the depressive symptoms in cancer remains underdeveloped and poorly implemented. We will evaluate the effectiveness and the implementation of an evidence-based HIT behavioral treatment for cancer patients with elevated depressive symptoms. This HIT treatment combines systematic, electronic health record-integrated screening for depressive symptoms with an individually-tailored HIT interventions to address gaps in the treatment of depression among cancer patients. The study takes place across two distinct health systems in two major metropolitan areas—Chicago and Miami (Northwestern Medicine and University of Miami Health System). We aim to conduct a pragmatic Type I effectiveness-implementation hybrid trial of My Cancer Support—an evidence-based, tailored behavioral HIT program for the management of elevated depressive symptoms—in ambulatory oncology care settings within two large health systems. We will establish the effectiveness of My Cancer Support on depressive symptoms(i.e., primary outcome) and anxiety, HRQoL, and health services use (i.e. secondary outcomes) compared to usual care. We will evaluate the process of implementing My Cancer Support and its impact on patient and system-level outcomes, including reach, adoption, maintenance, and acceptability. Next, we will identify facilitators and barriers to wide-scale implementation of My Cancer Support beyond Northwestern Medicine and University of Miami Health System. Finally, we will explore whether the effects of My Cancer Support vary across SES, language, disease severity, severity of depressive symptoms, recruitment sites, and other patient and clinical characteristics.

抽象的 抑郁症是整个癌症连续性中最常见的心理合并症之一。肿瘤患者的抑郁症状升高是一个主要问题，因为不受管理的抑郁症 癌症患者的症状与健康相关的生活质量差（HRQOL）有关，对 癌症治疗，延迟恢复工作和基线功能，更大的急诊室就诊，更大 自杀的风险和更高的全因死亡率。抑郁管理的行为干预措施是 这些基于证据的肿瘤学干预措施的有效，但可伸缩性和实施是有限的。 健康 解释 捕获 行为 人群。 信息技术（HIT）提供了一个理想的机会，可以加快管理，评分和评分 用良好的，简短和精确的测量工具进行抑郁筛查的筛查 可操作的数据以筛选抑郁症，并提供实用且可扩展的基于证据的数据 被证明可以减少其他各种抑郁症状的干预措施 尽管这些热门单曲的好处，但使用基于技术的模型筛选和交付 基于证据的行为治疗，以解决癌症抑郁症状的问题 欠发达且实施不佳。 我们 将要 评估一个有效性和实施 基于证据的抑郁症状癌症患者的示意性命中行为治疗。这个命中 治疗结合了系统的，电子健康记录的抑郁符号筛查 对癌症患者抑郁症治疗抑郁症的差距进行单独量身定制的命中干预措施。 该研究发生在两个主要都会区的两个不同的卫生系统（芝加哥和迈阿密） （西北医学和迈阿密大学卫生系统）。我们的目标是进行务实的I 我的癌症支持的有效性实施混合试验 - 基于证据的，量身定制的行为命中率 用于管理抑郁症状升高的计划 两个大型卫生系统。我们将确定我的癌症支持在抑郁症上的有效性 症状（即主要结果）和动画，HRQOL和健康服务的使用（即次要结果） 与通常的护理相比。我们将评估实施我的癌症支持及其对影响的过程 患者和系统级别的结果，包括覆盖范围，采用，维护和可接受性。接下来，我们会的 确定促进者和大规模实施我的癌症支持的障碍 医学和迈阿密大学卫生系统。最后，我们将探索我的癌症的影响 在SES，语言，疾病严重程度，抑郁症状的严重程度，招聘部位和 其他患者和临床特征。